The Rise in Trauma & Orthopaedic Trainee-Led Research and Audit Collaborative Projects in the United Kingdom Since the Start of the COVID-19 Pandemic (2022)

Type of publication:
Conference abstract

Author(s):
*Khaleeq T.; *Kabariti R.; *Ahmed U.

Citation:
British Journal of Surgery. Conference: ASiT Surgical Conference 2022. Aberdeen United Kingdom. 109(Supplement 6) (pp vi35), 2022. Date of Publication: September 2022.

Abstract:
Introduction: There has been a rise in trainee-led trauma & orthopaedic multi-centre research collaborative projects globally. These increase trainee involvement in research with an opportunity to deliver highly generalisable results on a particular topic. Objective(s): To evaluate the number of trauma & orthopaedic trainee-led research collaborative projects that took part since the start of the COVID-19 pandemic in the UK and compare them to projects from 2019. Method(s): This was a retrospective study that evaluated trauma & orthopaedic trainee-led national collaborative projects within the UK since the start of the COVID-19 pandemic lockdown (March 2020 to June 2021). Our exclusion criteria included any regional collaborative projects, pre Covid- 19 projects and projects of other surgical specialities. Result(s): In 2019, 0 trainee-led collaborative projects were commenced nationally in the UK. Since the COVID-19 pandemic, we identified 10 trainee-led collaborative trauma & orthopaedic projects with 6 being published so far. The level of evidence ranged between 3 and 4 and included 5 Audits and 5 cohort studies. The patients that were included in the studies ranged from 927 to 140,231 from a total of 2249 centres. Conclusion(s): Covid-19 has placed significant challenges across healthcare. However, one positive aspect is the increase in multi-centre trainee-led collaborative projects within the UK. Our study highlights the feasibility of a trainee-led high quality collaborative research projects in the UK and the availability of new tools such as social media and centralised confidential online databases such as Redcap facilitates such projects. Therefore, we recommend expanding this trainee-led collaborative platform in the field of trauma & orthopaedics worldwide.

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The Surgical Trainee Perception of the Operating Room Educational Environment (2022)

Type of publication:
Conference abstract

Author(s):
Rupani N.; Evans A.; *Iqbal M.

Citation:
British Journal of Surgery. Conference: ASiT Surgical Conference 2022. Aberdeen United Kingdom. 109(Supplement 6) (pp vi9-vi10), 2022. Date of Publication: September 2022

Abstract:
Aim: Limited hours and service provision are diminishing training opportunities for surgical trainees. It is therefore imperative to maximise each educational event in theatre. The Operating Room Educational Environment Measure (OREEM) evaluates each component of the theatre learning environment; however, it has not been validated in higher surgical trainees in England. We aim to validate the OREEM and evaluate surgical trainees' objective perspectives of the current operating room educational environment in one region. Method(s): Data was collected over one month from surgical trainees within Health Education Thames Valley using an online questionnaire consisting of: demographic data; the OREEM; a global satisfaction score. Result(s): 54 trainees participated. The OREEM had good internal consistency (alpha=0.906, variables=40) and unidimensionality. Mean OREEM score was 79.16%. Areas for improvement included better learning opportunities (72.9%) and pre/post-operative teaching (70.4%). Trainees were most satisfied with the level of supervision and workload (82.9%). No differences between gender (p=0.535) or hospital type (p=0.099) were demonstrated. The learning environment favoured senior trainees (p=0.017). There was a strong correlation between OREEM and the global satisfaction score (p<0.001). Conclusion(s): The OREEM was shown to be a reliable measure of the educational environment in theatre. It can be used to identify areas of improvement and as an audit tool. Suggested areas of improvement include facilitating pre- and post-operative teaching, reducing service provision, empowering trainees to plan lists, improving teamwork and using tools to optimise the educational value of each operation. There is a favourable attitude regarding the use of such improvement tools, especially for dissatisfied trainees.

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Effectiveness of a web-based virtual journal club to promote medical education (Web-Ed): protocol of a multicentre pragmatic randomised trial (2022)

Type of publication:Randomised controlled trial

Author(s):Michael Rimmer, Nagla Elfaki, Cheryl Dunlop, Damien Coleburt, Neil Cowan, Olivia Raglan, Jhia Jiat Teh, Maria Fisher, Sarah Mcrobbie, Nilaani Murugesu, Meera Ramcharn, Mohamed Abdelrahman, *Yazid Jibrel, *Matthew Wood, *William Parry-Smith, Bassel H Al Wattar

Citation:BMJ Open, 2022 Vol.12, Issue 6

Abstract:Introduction: A journal club (JC) is a commonly used medical educational tool. Videoconferencing technology can facilitate the delivery of JCs, however, there remains no evidence on the role of web-based virtual JCs in promoting the acquisition and retention of medical knowledge. The Web-Ed trial aims to evaluate the educational benefits, feasibility and acceptability of web-based virtual JCs compared with traditional face-to-face ones.

Methods and analysis: Web-Ed is a multicentre pragmatic parallel-group randomised trial across teaching hospitals within the UK National Health Service (NHS). We will enrol qualified doctors or medical students who are >18 years old, proficient in English and able to use online videoconferencing software. Block randomisation will be used to allocate participants in 1:1 ratio to either intervention group. Both groups will be presented with the same educational material and follow a standardised JC structure hosted by nominated moderators and medical faculty members.

The primary outcome is the difference in participants’ knowledge acquisition and retention 7 days after the JCs evaluated using standardised multiple-choice questions. We will report secondarily on the feasibility and acceptability of the JCs using Likert scale questionnaires. Assuming a 30% drop-out rate, we aim to enrol 75 participants to detect a 20% improvement in knowledge acquisition at 80% power and 5% significance. We will report using mean difference or risk ratio with 95% CIs and assess significance using parametric/non-parametric testing. Where relevant, we will adjust for predetermined characteristics (age, grade of training and session duration) using multivariate regression analyses.

Ethics and dissemination: Web-Ed was designed by doctors in training to address their learning needs and evaluate the preferred mode of learning. The trial results will be published in peer-reviewed journals and presented at relevant scientific conferences. The trial has been approved by the NHS Health Regulation Authority (21/HRA/3361).

Trial registration number: ISRCTN18036769.

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#OrthoTwitter: social media as an educational tool (2020)

Type of publication:Journal article

Author(s):Sahu MA; Goolam-Mahomed Z; Fleming S; *Ahmed U

Citation:BMJ Simulation & Technology Enhanced Learning, 2020 Sep 07; Vol. 7 (5), pp. 277-284

Abstract:Aims: The increased use of social media creates opportunity for new, effective methods of delivering medical and clinical education. Twitter is a popular social media platform where users can post frequent updates and create threads containing related content using hashtags. This study aims to investigate and analyse the type of content relating to orthopaedic surgery that is being posted on the platform of Twitter.Methods: A retrospective search was performed for tweets containing the words 'orthopaedic surgery' or 'orthopedic surgery' or the use of the hashtag '#OrthoTwitter' between November 2018 to November 2019. A total of 5243 tweets were included.Results: Tweets containing 'orthopaedic surgery' or 'orthopedic surgery' most frequently contained promotional or marketing content (30% promotional, 21% marketing), and private organisations were the category of author to which the greatest number of tweets belonged (30%). Tweets containing educational or research content were the least common among all tweets containing 'orthopaedic surgery' or 'orthopedic surgery' (11%). In contrast, of the tweets containing the hashtag '#OrthoTwitter', 44% contained educational or research content, 15% contained promotional content and no tweets containing marketing content. Furthermore, 87% of all tweets using the hashtag '#OrthoTwitter' were from orthopaedic surgeons, and the least number of tweets were from private organisations (2%).Conclusion: Twitter is a widely used social media platform regarding orthopaedic surgery. We propose that the hashtag '#OrthoTwitter' can be used to create an online community of orthopaedic surgeons where members can assist one another through sharing reliable and educational content.

The effect of the measures taken during the coronavirus pandemic on specialty trainees in obstetrics and gynaecology in the United Kingdom: an online questionnaire survey in one region (2022)

Type of publication:
Journal article

Author(s):
Elghobashy M; Stout A; Hatti A; *Smotra G; El-Ghobashy A

Citation:
Journal of Obstetrics and Gynaecology. 42(5) (pp 1455-1460), 2022. Date of Publication: 2022.

Abstract:
The coronavirus pandemic (COVID-19) has had unprecedented effects on healthcare delivery. A 34-question online survey was sent to obstetrics and gynaecology trainees within the West Midlands to assess the impact of the pandemic on training, working practices and well-being. 101 responses were received from obstetrics and gynaecology trainees. Trainees reported a significant reduction in both elective and emergency surgeries as well as outpatient clinics. Over one third of respondents felt additional training time may be required following reduction of clinical opportunities. 44% of trainees felt their workload increased significantly. 55% of trainees felt the pandemic had a significant negative impact on their physical and mental well-being. Obstetrics and gynaecology trainees in the West Midlands have adapted to the challenges of the COVID-19 pandemic despite significant impact on their training, working practices and wellbeing. It is important to tailor training to improve trainees' education and combat lost training time during the pandemic. This should be considered for long-term shaping of the obstetrics and gynaecology training pathway. IMPACT STATEMENT What is already known on this subject? Little research is available about the impact of the COVID-19 pandemic on obstetrics and gynaecology trainees. This is the first study of its kind to assess the effect of the pandemic on obstetrics ang gynaecology trainees in the United Kingdom. What do the results of this study add? The results of this study have shown that obstetrics and gynaecology training has been heavily affected during the COVID-19 pandemic. There have been significant impacts on their training, working patterns and physical and mental wellbeing. What are the implications of these findings for clinical practice and/or further research? These findings can be used to mould the obstetrics and gynaecology training pathway based on the feedback given by the trainees during the pandemic. The survey questions can also be utilised as a framework for similar research projects across the United Kingdom Deaneries, among other specialties and around the world.

Organising a surgical conference during the COVID-19 pandemic-is it 'virtually' the same? (2021)

Type of publication:Conference abstract

Author(s):Hashmi Y.; Sahu M.A.; Hatt K.; Osman S.; Bhuiyan Z.A.; *Ahmed U.

Citation:British Journal of Surgery; Sep 2021; vol. 108, Supplement 6

Abstract:Introduction: Surgical conferences are invaluable events for healthcare professionals; they provide opportunities to engage with upcoming scientific discoveries, network professionally with peers as well as expand learning through lectures and workshops. For medical students, conferences provide an opportunity to expand understanding beyond the undergraduate curriculum in an interactive manner. COVID-19 has caused disruption to the organisation and attendance of in-person conferences (IPCs). Virtual conferences (VCs) offer a viable solution, allowing delegates to attend from the comfort of their own homes. Method(s): The aim of our study was to evaluate an organised VC and explore the perceived benefits and limitations of VCs compared to IPCs. A virtual one-day trauma & orthopaedics (T&O) conference was organised involving lectures, workshops, poster, and oral presentations. Anonymous questionnaire forms were distributed to delegates following the conference to assess the aims of our paper. Result(s): From 106 responses, 96.2% rated the conference as 'Excellent' or 'Good' with 92.5% stating that it increased their passion for T&O surgery. Based on a five-point Likert scale (5= strongly agree, 1= strongly disagree), mean score of agreement for preferring VCs to IPCs was 3.30(+/- 1.24). Key advantages of the VC were a lower cost (70.8%) and not having to travel (77.4%), whereas the main limitation was the inability to participate in hands-on workshops (84.9%). Conclusion(s): Despite the success of our VC, delegate feedback indicates a mixed response comparing VCs to IPCs. We share our findings to encourage similar events to be organised and for other specialties.

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The post graduate virtual learning environment: An effective platform for the delivery of a surgical teaching programme in the West Midlands (2021)

Type of publication:Conference abstract

Author(s):El-Sayed C.; *Ahmed U.; *Farquharson A.

Citation:British Journal of Surgery; Oct 2021; vol. 108, Supplement 7

Abstract:Aim: The Postgraduate Virtual Learning Environment (PGVLE) is a digital platform developed by HEEWM in response to the COVID-19 pandemic to deliver a virtual teaching programme to surgical trainees. The programme is delivered through the BigBlueButton; an integrated virtual classroom. All teaching sessions are recorded and archived to allow trainees to review content at their convenience. We performed a contemporaneous study to review the effectiveness and quality of the platform in delivering teaching and suggest its future role in the surgical curriculum. Method(s): Anonymised feedback was gathered of trainee's perspective of the platform experience, the quality of teaching and the archived content. All trainees were General Surgery higher trainees (HST) (ST3- ST8). The data from sequential teaching days was analysed. Result(s): Of 90 HST, on average 40 attended each monthly training day (consistent with pre-COVID attendance). 122 trainee responses were completed. 68% of respondents were between ST3-ST5. 91% rated the administration and delivery of the teaching sessions as excellent or very good. 16% of trainees watched the archived sessions after the teaching day of which 46% felt it met their educational expectations. Conclusion(s): The PGVLE is an effective platform for the delivery of a virtual surgical teaching programme. It met with high levels of trainee satisfaction in the context of the pandemic. The archived content provides advantages to consolidation of learning. It is thought that the PGVLE platform will become a key feature of the surgical training programme in a hybrid learning model, related to relevant curricula, in the future.

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Interactive teaching environment for diagnostic radiography with real-time X-ray simulation and patient positioning (2022)

Type of publication:Journal article

Author(s):Sujar, Aaron; *Kelly, Graham; García, Marcos; Vidal, Franck P

Citation:International Journal of Computer Assisted Radiology and Surgery; January 2022, 17(1), pages 85-95

Abstract:PURPOSE Traditional undergraduate radiographer training mixes academic lectures and clinical practice. Our goal is to bridge the current disconnection between theory and practice in a safe environment, avoiding the risk of radiation for both practitioners and patients. To this end, this research proposes a new software to teach diagnostic radiography using real-time interactive X-ray simulation and patient positioning. METHODS The proposed medical simulator is composed of three main modules. A fast and accurate character animation technique is in charge of simulating the patient positioning phase and adapts their internal anatomy accordingly. gVirtualXRay is an open-source X-ray simulation library and generates the corresponding radiographs in real time. Finally, the courseware allows going through all the diagnostic radiology steps from the patient positioning and the machine configuration to the final image enhancing. RESULTS A face and content validation study has been conducted; 18 radiology professionals were recruited to evaluate our software using a questionnaire. The results show that our tool is realistic in many ways (72% of the participants agreed that the simulations are visually realistic), useful (67%) and suitable (78%) for teaching X-ray radiography. CONCLUSIONS The proposed tool allows simulating the most relevant steps of the projectional radiography procedure. The virtual patient posing system and X-ray simulation module execute at interactive rates. These features enable the lectures to show their students the results of good and bad practices in a classroom environment, avoiding radiation risk.

Optimising frontline learning and engagement between consultant-led neonatal teams in the West Midlands: a survey on the utility of an augmented simulation training technique (2021)

Type of publication:
Journal article

Author(s):
Pillay, Thillagavathie; Clarke, Lynsey; Abbott, Lee; Surana, Pinki; Shenvi, Asha; *Deshpande, Sanjeev; Cookson, Joanne; Nash, Matthew; Fawke, Joe; Rasiah, Vishna; Cusack, Jonathan

Citation:
Advances in Simulation; Aug 2021; vol. 6 (no. 1); p. 29

Abstract:
BACKGROUND In England, neonatal care is delivered in operational delivery networks, comprising a combination of the Neonatal Intensive Care (NICU), Local-Neonatal (LNU) or Special-Care Units (SCU), based on their ability to care for babies with different degrees of illness or prematurity. With the development of network care pathways, the most premature and sickest are mostly triaged for delivery in services linked to NICU. This has created anxiety for teams in LNU and SCU. Less exposure to sicker babies has resulted in limited opportunities to maintain expertise for when these babies unexpectedly deliver at their centre and thereafter require transfer for care, to NICU. Simultaneously, LNU and SCU teams develop skills in the care of the less ill and premature baby which would also be of benefit to NICU teams. A need for mutual learning through inter-unit multidirectional collaborative learning and engagement (hereafter also called neonatal networking) between teams of different designations emerged. Here, neonatal networking is defined as collaboration, shared clinical learning and developing an understanding of local systems strengths and challenges between units of different and similar designations. We describe the responses to the development of a clinical and systems focussed platform for this engagement between different teams within our neonatal ODN. METHOD An interactive 1-day programme was developed in the West Midlands, focussing on a non-hierarchical, equal partnership between neonatal teams from different unit designations. It utilised simulation around clinical scenarios, with a slant towards consultant engagement. Four groups rotating through four clinical simulation scenarios were developed. Each group participated in a clinical simulation scenario, led by a consultant and supported by nurses and doctors in training together with facilitators, with a further ~two consultants, as observers within the group. All were considered learners. Consultant candidates took turns to be participants and observers in the simulation scenarios so that at the end of the day all had led a scenario. Each simulation-clinical debrief session was lengthened by a further ~ 20 min, during which freestyle discussion with all learners occurred. This was to promote further bonding, through multidirectional sharing, and with a systems focus on understanding the strengths and challenges of practices in different units. A consultant focus was adopted to promote a long-term engagement between units around shared care. There were four time points for this neonatal networking during the course of the day. Qualitative assessment and a Likert scale were used to assess this initiative over 4 years. RESULTS One hundred fifty-five individuals involved in frontline neonatal care participated. Seventy-seven were consultants, supported by neonatal trainees, staff grade doctors, clinical fellows, advanced neonatal nurse practitioners and nurses in training. All were invited to participate in the survey. The survey response rate was 80.6%. Seventy-nine percent felt that this learning strategy was highly relevant; 96% agreed that for consultants this was appropriate adult learning. Ninety-eight percent agreed that consultant training encompassed more than bedside clinical management, including forging communication links between teams. Thematic responses suggested that this was a highly useful method for multi-directional learning around shared care between neonatal units. CONCLUSION Simulation, enhanced with systems focussed debrief, appeared to be an acceptable method of promoting multidirectional learning within neonatal teams of differing designations within the WMNODN.

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